胃间质瘤37例诊治及预后分析

目的]探讨胃间质瘤（GST）临床病理特点、手术治疗及预后。方法]回顾性分析1997—2007年间37例手术切除的GST临床病理资料。结果]37例GST中肿瘤位于胃底部、胃体部、胃窦部分别为6例、11例、20例，肿瘤平均直径5．45±4．53cm。免疫组化分析CD117阳性表达率为97．0％。全组35例施行肿瘤完全切除术，另2例分别行姑息切除或活检。32例患者获随访，1、3、5年生存率分别为97．O％、88．2％、81．1％。Fletcher恶性风险分级与生存率密切相关（P=O．002），极低度、低度、中度风险组与高度风险组间生存率差异有显著性意义（P值均〈0．05）。结论]应高度重视GST初次手术的完全切除，对恶性风险较高的GST需积极施行切除范围较大的手术治疗。

An Analysis of Diagnosis, Treatment and Prognosis in 37 Cases with Gastric Stromal Tumor

Purpose] To investigate the clinicopathological features, surgical treatment and prognosis of gastric stromal tumor（GST）. Methods} The clinicopathological data of 37 patients with GST undergoing surgical treatment from 1997 to 2007 were analyzed retrospectively. Results] Of 37 cases with GST, 11 cases located at the fundus of stomach, 20 cas- es at the gastric body, 6 cases at the gastric antrum. The average diameter of tumors was 5.45±4.53cm. Positive expression rate of CDll7 determined by immunohistochemical method was 97.0%.Thirty-five cases underwent complete tumor resection; 2 cases, pallia- tive resection or biopsy. Of 32 cases followed up, the overall 1,3,5-year survival rate was 97.0%,88.2% and 81.1% respectively. Fletcher malignant risk grading for GIST closely re- lated to survival rate（P=0.002）. Survival rate among very low, low, intermediate and high- risk group was significantly difference （P〈0.05 respectively）. Conclusion ] Complete tumor resection for GST in the initial operation should be emphasized. Extended surgical resection is required for GST with higher malignancy risk.